title: Conservative management of tumors of the rectum by radiotherapy and local excision.
abstract: Twenty-five patients with invasive adenocarcinoma of the rectum were treated by preoperative external irradiation (35 Gy), local excision, and peroperative placement of a plastic tube loop in the tumor bed for perioperative brachytherapy (20 or 25 Gy). Patients treated were too frail for radical resection (14 patients) or had refused a permanent colostomy (11 patients). With a mean follow-up of 40.5 months, there have been 5 patients with local relapse, 3 of whom had salvage abdominoperineal resections: 2 have no evidence of disease and 1 has developed distant metastatic disease. The 20 patients with local control have normally functioning sphincters; 1 has developed distant metastatic disease. This combined approach was designed to expand the curative role of local resection in carcinoma of the rectum. The surgical techniques are thoroughly described and the potential role and indications of this approach are discussed.
authors.affiliation: Department of Surgery, CHU Henri Mondor, Créteil, France.
authors.forename: J
authors.initials: J
authors.lastname: Despretz
authors.forename: Y
authors.initials: Y
authors.lastname: Otmezguine
authors.forename: L
authors.initials: L
authors.lastname: Grimard
authors.forename: E
authors.initials: E
authors.lastname: Calitchi
authors.forename: M
authors.initials: M
authors.lastname: Julien
mesh_terms: D000230:Adenocarcinoma / Q000473:pathology / Q000532:radiotherapy / Q000601:surgery*; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001918:Brachytherapy; D002985:Clinical Protocols; D003131:Combined Modality Therapy; D005500:Follow-Up Studies; D006801:Humans; D007496:Iridium Radioisotopes / Q000627:therapeutic use; D008722:Methods; D008875:Middle Aged; D009362:Neoplasm Metastasis; D009364:Neoplasm Recurrence, Local; D012004:Rectal Neoplasms / Q000473:pathology / Q000532:radiotherapy / Q000601:surgery*
chemical_list: D007496:Iridium Radioisotopes